Evaluation of an Optical Defocus Treatment for Myopia Progression Among Schoolchildren During the COVID-19 Pandemic

• Published in: JAMA network open 2022-01, Vol.5 (1), p.e2143781-e2143781
• Main Authors: Choi, Kai Yip, Chun, Rachel Ka Man, Tang, Wing Chun, To, Chi Ho, Lam, Carly Siu-Yin, Chan, Henry Ho-Lung
• Format: Article
• Language: English
• Subjects: Child; Coronaviruses; COVID-19; COVID-19 - epidemiology; Disease Progression; Eyeglasses; Female; Humans; Male; Myopia - physiopathology; Myopia - therapy; Online Only; Ophthalmology; Original Investigation; Pandemics; Quarantine; Refraction, Ocular; SARS-CoV-2; Social Isolation
• ISSN: 2574-3805; 2574-3805
• DOI: 10.1001/jamanetworkopen.2021.43781

Myopia progression has been found to be worsening during the COVID-19 pandemic. It is important to control the rapid myopia progression in this period. To analyze the association of COVID-19-related lockdown measures with myopia progression in schoolchildren and to compare the performance of defocus incorporated multiple segments (DIMS) lens with that of single vision lens (SVL) treatment in reducing myopia progression. This cohort study involved an exploratory, prespecified, comparison of 2 independent longitudinal studies performed at the same institute beginning in 2019. Data from Hong Kong schoolchildren (aged 7-13 years) were gathered and analyzed. Data analysis was performed from June to July 2021. Schoolchildren in study 1 wore a DIMS lens for 18 months, and those in study 2 wore a SVL for 24 months. Cycloplegic spherical equivalent refraction and axial length were measured. Studies 1 and 2 started before the start of lockdown measures and continued throughout the lockdown. In both studies, periods of fewer and more COVID-19-related lockdown measures were identified. Because COVID-19 lockdown caused deviations from the visit schedule, myopia progression was normalized to 12-month change, which were compared between DIMS and SVL groups, also during the periods with less and more lockdown time. There were 115 participants (58 girls [50.4%]; mean [SD] age, 10.3 [1.5] years) in the DIMS group; their mean (SD) baseline refraction was -4.02 (1.46) D. There were 56 participants (29 girls [51.8%]; mean [SD] age, 10.8 [1.5] years) in the SVL group; their mean (SD) baseline refraction was -2.99 (1.06) D. After controlling for the covariates, DIMS treatment was significantly associated with 34% less axial elongation (0.19 mm [95% CI, 0.16 to 0.22 mm] vs 0.30 mm [95% CI, 0.25 to 0.35 mm]; P